The Effect of Oral Immunotherapy on Preterm Neonates: A Promising Adjuvant Therapy in a Clinical Trial Study.

Abstract

Background: Breastfeeding is currently recommended as the optimal and initial feeding option for all newborns, as it protects against illness and reduces neonatal mortality. Furthermore, premature infants exhibit reduced swallowing ability and an increased risk of developing necrotizing enterocolitis (NEC), which may hinder suckling and delay the initiation of enteral feeding.

Aim: To investigate the effects of oropharyngeal colostrum delivery in preterm neonates < 34 weeks' gestation on hospital outcomes, specifically differences in hospital stay between neonates who received colostrum for three days and those who did not.

Methods: This prospective, interventional, randomized controlled trial enrolled ninety-six preterm neonates, who were allocated into three groups: Group A, neonates who received oropharyngeal colostrum for 3 days along with routine care; Group B, neonates who received oropharyngeal colostrum for 10 days along with routine care; and Group C, neonates who received routine care only. The Kruskal-Wallis test was used to compare medians among the three groups. Associations between categorical variables were analyzed using the chi-squared test and Monte Carlo test.

Results: The two groups that received colostrum showed significantly reduced median hospital stays, time to reach full enteral intake, and sepsis rates compared to the control group (P < 0.001). A significant difference in daily weight gain was observed between groups, particularly between the control group and neonates who received colostrum for 10 days (P = 0.028). Regarding the incidence of NEC, no significant difference was found among the groups (P = 0.314).

Conclusion: Oropharyngeal colostrum may be considered a potential oral immunotherapy.